Numbers on both undergraduate and pre-registration UK nursing courses have declined in the last four years in spite of efforts to address the drop-off.
UCAS figures showed a 22% decrease in enrollment on undergraduate nursing courses between 2021 and 2024 while the Royal College of Nursing (RCN) reported a 35% drop in applications to all nursing courses in England since 2021.
The decline follows a spike in nursing applications following the Covid-19 pandemic with just shy of 60,000 (59,680) students enrolling on nursing undergraduate courses in 2021 in the UK, and comes despite the NHS Long Term Workforce plan to almost double adult nursing trainee numbers by 2031/32.
Royal College of Nursing London director Lisa Elliot said: “The Covid-19 crisis demonstrated the very best of nursing and it was a reminder to the public why nursing is such a fantastic career.
“There was a brief increase in nursing course applications during the pandemic but this uptick in applications wasn’t sustained.”
Regionally, London has seen the smallest decline in applications to undergraduate nursing courses between 2020 and 2023 at 11.7%.
The greatest decline has been in the North East at 40%.
Elliot also cited the financial toll of student debt and the cost of living, particularly for nursing students working in the capital, as factors contributing to drop-out rates.
The RCN reported more than one fifth (21%) of UK nursing students are expected to quit their studies before completion.
Elliot said: “We’re calling on the government to take ownership of nurses’ student debt and introduce a loan-forgiveness model for nursing staff, in return for working in the NHS and public services for a set period of time before completing their degree.”
Ellie, 22, who is due to attain her BSc in Adult Nursing at University of Essex this year, said that of the 120-person capacity on her course, only 70 students applied.
She added a number of students dropped out in both first and second year, with around 45 remaining in her cohort.
Ellie outlined how 60 to 70-plus hour work weeks are often demanded of nursing students, who usually need to work to sustain a steady income alongside the weekly 40 hours of unpaid work placements the degree requires.
She said: “The cost of living definitely plays a massive role [in the drop in nursing course enrollment and high drop-out rates]
“Another reason for the decline is the mental physical toll the course takes on you.
“They’re very long days, without pay, there is no incentive in that aspect.
“Of course, gaining the degree is amazing, but the worry of being able to afford things or being in debt is a massive factor.”
Despite the RCN’s reports there are 6,000 unfilled NHS nursing vacancies in London alone, Ellie has struggled to find a job for when she is newly-qualified.
She said: “The struggle of finding a job is absolutely dire.
“If you research through TRAC and NHS jobs, the majority of them require you to have at least six months experience.
“As a newly qualified, that is completely impossible.
“Being told after studying for three years and ending up in mass amounts of debt, that I may not be able to choose a job in a place that I want to work and that will benefit me and my future career is disgusting.”
Jess, 27, is studying a dual masters in adult nursing and mental health care at City St George’s University of London, and is due to graduate in June.
She also explained that a lot of the newly-qualified nurses she had spoken to had been having difficulties finding jobs.
Jess said: “There are a lot of cuts and not many newly qualified jobs going… and then you go on the ward and they’re really short [of staff].
“There are a lot of hoops to jump through and red tap [for a trust to create a new nursing role].”
Despite the downfall in nursing course enrollment numbers, Kingston University, which was ranked No.1 in London for nursing courses in The Times Good University Guide 2025, appears to have bucked the trend.
A spokesperson said: “Although we are aware of a decline in applications onto nursing courses over the last few years, which is mainly due the effect of the cost of living crisis and a return to pre-pandemic levels applicant numbers, at Kingston, we have seen an increase in the number of students accepting places on our nursing courses in each of the last two years and we hope this trend will continue as we seek to educate the nurses of tomorrow.”
A Department of Health and Social Care Spokesperson said: “It is unacceptable that some student nurses are experiencing difficulties securing a role after qualifying.
“We are working closely with NHS England, employers and educators to improve transition into the workforce.
“We will publish a refreshed workforce plan later this year, to ensure the NHS has the right people in the right places with the right skills.”
Picture credit: Free to use from Unsplash
Join the discussion